FAMILY RESEARCH REQUEST
                     (GENEALOGY FORM)
               Westminster Historical Society


Please fill out this Family Research Request form and send to the Westminster Historical Society, PO Box 177,
Westminster, MA 01473.  The research fee is $20 an hour.  Please advise us how much time you would like us to spend on
finding the information. _______ hour/s.

Name of person requesting information.

Name ________________________________________        Date _____________

Address __________________________________________________________

City        _____________________        State ___________        Zip ______________

Tel. (Home) _____________________        Tel. Cell ___________________

Email __________________________________________________________


Name of person to research: _______________________________________________________________________

Describe in detail the question you want answered. Give as much background information as you can.